Open Journal of Stomatology, 2013, 3, 52-57

http://dx.doi.org/10.4236/ojst.2013.31010 Published Online March 2013 (http://www.scirp.org/journal/ojst/)

OJST

Influence of teeth on the smile and physical attractiveness.

A new internet based assessing method
Yoann Lopez1,2, Jrmie Le Rouzic1,2, Valrie Bertaud1,2,3, Matthieu Prard1,2,4, Justine Le Clerc1,2,4,
Jean-Marie Vulcain1,2*
1

Facult dOdontologie, Universit de Rennes 1, Rennes, France

CHU Rennes, Ple dOdontologie et Chirurgie Buccale, Rennes, France
3
EA 3888, IFR 140, Facult de Mdecine, Universit de Rennes 1, Rennes, France
4
U6226, CNRS, Sciences Chimiques de Rennes, Equipe de Biomatriaux en Site Osseux, Rennes, France
Email: *jean-marie.vulcain@univ-rennes1.fr
2

Received 19 January 2013; revised 24 February 2013; accepted 5 March 2013

ABSTRACT

1. INTRODUCTION

Objectives: Traditional methods for evaluating aesthetic perceptions of the teeth have involved panels of
people observing photographs, and the person commenting on the appearance of the teeth generally is
aware that his opinion of the dental appearance is
being sought. The situation is artificial and may involve bias. We propose a novel method for evaluating
the effect of dental imperfections on perceptions in
which the participant is unaware of participating in a
survey and in which his or her opinion is not sought.
Rather, involvement in the study betrays the importance of dental aesthetics for the observer. Methods:
Starting with a digitally manipulated photograph of a
smiling young woman, two portrait photographs A
and B were produced in which the only differences
were in the dentition revealed by the smile. The two
photographs were anonymously posted on an online
dating service site covering two large cities in southwestern France. During a period of one month, all
hits on each of the photographs and all attempts to
make contact were counted. Results: There was no
significant difference between the number of hits on
each of the portraits A and B. On the other hand, the
ratio of attempts to contact to hits showed a clear difference: the ratio was 4.8 times greater for Portrait A
than for Portrait B (p < 0.001). Conclusions: Digital
manipulation of a photograph and internet dating
sites provide an alternative to traditional questionnaires for evaluation of the contribution of dental
factors to a persons physical attractiveness.

Physical appearance, especially that of the face, plays a

key role in human communication. The mouth is a critical inter-relational crossroads, both physiologically and
socially. In this context, teeth that are visible when smiling are important.
In 1972, Dion et al. [1] defined the physical attractiveness stereotype as what is beautiful is good. Several years later, the meta-analyses of Eagly et al., Feingold, and Jackson et al. [2-4] of showed that people considered to be beautiful are perceived to be extroverted,
popular, sociable and thus appeared more attractive and
happier. This is why cosmetic surgery seeks to increase
an individuals attractiveness [5].
The role of teeth in the perception of beauty has been
widely accepted, including by the American Academy
of Cosmetic Dentistry, and as a result of a study conducted by Beall [5] in which only aesthetic dentistry
achieved results close to cosmetic surgery. This raises
the question of the ability of cosmetic dentistry to make
the individual more attractive, since the study of Beall [5]
showed clearly that the smile has a major impact on the
physical attractiveness of the person. People considered
beautiful are perceived as having desirable social qualities. The smile alone has a significant positive impact on
the overall attractiveness and perception of personality.
Similarly, the appearance of the smile has a significant
association with the initial success of an encounter. For
Berry and Miller [6], physical appearance in general and
especially the smile are more critical for men than for
women. Trivers parental investment model [7] had already defined the concept: women consider the skills
necessary to progress in society to be more important
than physical appearance.
In this context, cosmetic dentistry plays an undeniable
role in one persons acceptance by another. A beautiful
dental appearance is considered essential in certain oc-

Keywords: Dental Aesthetics; Smile; Appearance;

Communication; Internet
*

Corresponding author.

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Y. Lopez et al. / Open Journal of Stomatology 3 (2013) 52-57

cupations, such as acting or modelling. Several studies in

the United States conducted among former MBA students show that there is a very strong correlation between
rank on a scale of beauty and professional income. For
each additional unit on the scale of beauty, men earned
$2600 more per year and women $2150 more than their
counterparts [8].
Similarly, several studies cited above have shown that
individuals who met the criteria for physical beauty were
more relaxed and more sociable. Langlois et al. reported
in a meta-analysis that a telephone survey had established a clear correlation between the perception of sociability of a group of respondents and judgments about
the physical attractiveness of the same group [9].
This propensity toward physically beautiful people in
is not seen just in adults, it is the continuation of a behaviour that appears early in childhood. It has been
shown that children with normal dento-facial appearance
were considered more beautiful, more desirable as
friends and even more intelligent than those with Angle
class III or class II occlusions, irrespective of sex [10].
This subject was also investigated by Fonte et al. [11],
who evaluated the influence of dentofacial appearance on
the interpersonal attractiveness of 802 Brazilian children
aged 10 years. From an original face altered by computer
to create three virtual faces, the first met normal aesthetic
standards, the second had an Angle Class II occlusion
and the third an Angle Class III occlusion. The first face
was preferred by 68.9% of children.
Other studies by Mandall et al. and Al-Sarheed et al.
[12,13], reported similar results. OBrien et al. [14] even
suggested that the motivation behind demand for orthodontic treatment in adolescents is associated more with
the social implications of malocclusion rather than functional considerations.
Finally, Grzywacz [15] confirmed that adolescents attach great importance to cosmetic dentistry; he reported
that 100% of a cohort of 84 young people aged 12 years
considered the dental arch important in aesthetic facial
appearance.

2. AIMS OF THE STUDY

In all the previously reported studies, the dental factor
either was evaluated in the presence of other parameters
or was confused with the smile; furthermore, most of the
investigations were carried out by comparing the faces of
different individuals. In a face, many parameters, such as
eye colour, nose shape, the hair, the presence or absence
of malformations, etc., as well as the smile and the teeth,
contribute to the assessment of the individual.
But what is the real importance of the dental factor
compared with other features? What is the impact of the
teeth?
In this study, our goal was to test a new method of aesCopyright 2013 SciRes.

53

thetic assessment using an Internet dating site, to evaluate the importance of physical attributes to a persons
attractiveness. A secondary objective was to test this
method by assessing the physical attractiveness of a face
in which all parameters were constant except for the
dental factor, thus measuring the influence of the teeth in
the perception of an individual.

3. MATERIAL AND METHODS

Using as the starting point an image of a face of a Caucasian female of about thirty years of age, meeting the
aesthetic criteria of Paris and Faucher [16], an anonymous digital portrait was created using image manipulation software (Gimp 2; http://www.gimp.org/), then
duplicated to obtain two identical images.
The first image, given the identification A, was used
without modification. In the second, identified as B,
dental features were modified using the same software.
While maintaining the same labial outline, a series of
transformations was performed, applying fundamental
criteria of cosmetic dentistry, as defined by Paris and
Faucher [16], and those of Fradeani [17], concerning the
aesthetics of the smile. The following changes were implemented:
- The right maxillary second premolar (tooth 15) and
the left maxillary first premolar (tooth 24) were repositioned;
- The right maxillary central incisor (tooth 21) was
rendered slightly grey in colour;
- The left maxillary central incisor (tooth 11) was repositioned slightly labially;
- The neck of the right maxillary lateral incisor (tooth
22) was displaced in an incisal direction;
- The cuspal tips of the maxillary canines were accentuated.
The two portraits, A (Figure 1) and B (Figure 2) thus
obtained could be superimposed as all their features, including the lips, were identical. Only their dental characteristics were different.
To assess the impact of the dental features on perceptions of the faces A and B in the most objective way possible and without investigator intervention, it was decided to place these two faces on an Internet dating site.
The selected site is a leader in the field in France and
advertises itself regularly on television channels. A fictitious background, identical for the two portraits except
for residence, was created to give the two faces a personality as close as possible to character traits and interests
prevalent in the general population and particularly in
this type of profile (Figure 3).
So that the two portraits did not appear concomitantly,
they were published in two different cities corresponding
to the apparent places of residence. Two cities in southwest France, Bordeaux and Toulouse, were chosen. They
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Y. Lopez et al. / Open Journal of Stomatology 3 (2013) 52-57

54

Figure 1. Portrait A.

Figure 2. Portrait B (digitally modified).

Listing details

Portraits A and B

Date of birth

05/01/1986

Place of residence

Bordeaux, portrait B
Toulouse, portrait A

Language spoken

French

Intentions

Stable relationship

Marital status

Single

Profession

Nurse

Height

170 cm

Figure

Slim

Hair colour

Brown

Eye colour

Chestnut

Children

None

Most marked characteristic

Shy, reserved

Tobacco

Non-smoker

Likes going out to...

Hobbies
Sporting activities

Restaurants, family, theatre, concerts,

cinema, evenings with friends,
other
Shopping, art exhibitions/museums,
cooking, travelling, walking, animals,
art, others
Swimming, ski/snowboard,
horse riding, hiking/trekking, fitness.

Figure 3. Background of the profile.

Copyright 2013 SciRes.

are similar in their demographic structure [18] and are

culturally similar. Bordeaux has a population of about
240,000 and Toulouse of about 440,000 persons and
each city is surrounded by a larger populated area. The
city of Bordeaux was selected at random as the place of
residence for picture B and Toulouse for picture A. Apart
from the dental differences between the images, residence was the only variable that differed between the
portraits. The two cities are about 240 km apart, so it was
considered unlikely that the two portraits would appeal
to the same persons.
Like other members of the site, each of the portraits A
and B was allocated an e-mail address for receiving
messages from other site members. When a person
searches, a dozen profiles corresponding to the desired
criteria are presented, with a thumbnail photograph too
small to show the full details of the face. It is only when
a visitor clicks a profile that it is displayed in full screen
with high resolution, allowing a clear view of all the
features of the face, including the smile and the teeth.
Then the visitor can, if he wishes, contact the person by
e-mail. The site remembers and tells the owner of the
account the number of members who visited the profile
and the number of members who sent an email.
Portraits A and B, with their background information,
were left on the site for one month exactly (23 May 2011,
23:00 hours to 22 June 2011, 23:00 hours), at the end of
which time the number of hits on the individuals and the
number of e-mails received were noted. The outcome
measure of interest was the proportion of hits that resulted in an e-mail. To avoid over-estimating the number
of hits and e-mails, only the first hit and only the first
contact was counted for each portrait, even when a person made several visits or sent several e-mails.
In a pilot test, it was found that any administrator connection to an account was included in the hit count and
could lead to bias, by increasing the number of visits. To
avoid this, only two connections were allowed, the first
to open the account and insert the portrait on the site, the
second to close the account. No further administrator
intervention was undertaken during the period of the
study.
The numbers of E-mails as a proportion of hits were
compared using chi-square (1 df, = 5%). This proportion is independent of the population sizes of the cities.
The numbers of hits on each portrait was similarly tested
(2; 1 df, = 5%).
The study protocol was reported to and approved by
the CNIL (National Committee for Informatics and Freedom) (Declaration #1562741 v 0).

4. RESULTS
Portrait A and Portrait B received respectively 425 and
461 visits during the month, an average of 13.7 daily hits
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to the portrait A and 14.8 to portrait B. This difference

was not statistically significant (2 = 1.46; 1 df; p >
0.10).
During the same period, these visits were followed up
by 71 e-mail contact requests to portrait A, a daily average of 2.29 e-mails; 16.7% of hits resulted in e-mails.
For Portrait B, there were 16 contact e-mails, a daily
average of 0.51 and just 3.47% of hits resulted in e-mails.
The difference was statistically significant (2 = 43.73; 1
df; p < 0.001; Figure 4).
Portrait A received statistically significantly more
e-mails than did Portrait B.

5. DISCUSSION
The results indicate significantly and unambiguously that
the dental factors play an important role in the physical
perception of an individual and consequently in the establishment of a social relationship. The score of Portrait
A, which corresponded with the aesthetic dentistry criteria defined by Paris and Faucher [16], is four times
higher than the score obtained by Portrait B. The importance of aesthetic dental appearance would appear to be
supported.
It should be recalled that this test was performed using
a womans face and it is likely that the vast majority of
visitors were of the opposite sex. It would have been
instructive simultaneously to use the same approach with
a male portrait.
Digital manipulation seems well suited to this type of
investigation; the digitisation of photographs allows all
appearance features to be changed more and more precisely and a number of other studies have also used this
method [11,19]. In this study, the dental characteristics
were transformed significantly. Would more or less severe modifications have modulated the result? This question must be addressed in a wider study.
The internet dating site, which was used in an original
way in this study, served as an independent tool, anonymous and reliable for quantifying data. It reduced the
administrative effort required for the investigation and
the time spent to acquire data. It was unaffected by any
lack of objectivity in the investigator. In addition, it allowed full control of time, whether by the month exactly
or by the hour precisely; it would allow decoys to be
used to increase the accuracy of the results, and the investigation can be repeated as necessary. In this study we
Daily
e-mails
mean hits received

Portrait

Hits

425

13.7

461

14.8

NS

Figure 4. Results.
Copyright 2013 SciRes.

Daily mean
e-mails

e-mails/Hits
(%)

71

2.29

16.70%

16

0.51

3.47%
p < 0.001

55

chose a very popular dating site but it could have been a

professional recruitment site, although with a risk of
more limited and more specific participation. The option
of using two separate cities of residence, while creating
an additional variable in the study, does not seem to have
had any influence on the results. Indeed, the populations
of these cities are similar, in terms of demographics, social culture and standard of living. This makes two relatively homogeneous source populations, which may explain why the number of hits received in each place of
residence showed no significant difference.
Previous studies on this subject are qualified by possible biases resulting from the fact that the findings on
dental criteria were obtained in the presence of other
variables, and certainly on different faces. Often, respondents are directed to look especially at the teeth and their
responses may be affected by this. This was not the case
in the present study, where respondents interests were
social contact and they were unaware that they were participating in a study. Digital photography now makes it
possible to manipulate the key elements of an image,
such as the teeth, while maintaining everything else constant; this was a strong point of this investigation.
The choice of physical features and background characteristics of the two portraits, such as the profession of
nurse (generally well regarded), was done in order to
attract as many hits as possible. The main aim was to
increase the power of our statistical tests. The number of
hits, 425 for portrait A and 461 for Portrait B, seems to
justify the choices made.
The scientific literature is in agreement that the smile
and the teeth play a significant role in rendering a face
attractive. They can convey an impression of social success and good health but subjectivity predominates in
assessing their involvement, and outcome measures dependent on the cultural context [20]. On the other hand,
the majority of studies focus on the smile [5,16,17,19,20],
yet the smile is multi-factorial. Van der Geld et al. [21]
have identified and quantified the elements that make the
smile attractive: the size of the teeth, lip position and the
extent of gingival display.
The study of De Deus et al. [19] is the closest to the
one we present. Indeed, from one face, the authors developed a series of five digitally manipulated images of a
smile, each with a different dental criterion, such as a
smile combined with midline displacement or a smile
combined with a diastema. A hierarchy of smiles was
then formally established by a group of ten women and
ten men.
The present study, the results of which are generally in
accordance with the literature, has several merits: firstly,
only the dental parameters vary while all the other factors involved in the attractiveness of a personare maintained constant; secondly, it invites evaluation of the
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56

modification by persons who do not know they are participating in a test, an original method; and, finally, it
attracts a sufficiently large number of opinions to permit
statistically reliable conclusions.
The result of this study shows clearly that the teeth affect the perception of a person. This result therefore underlines the potential of cosmetic dentistry. It would be
interesting to conduct a similar study by restoring the
maxillary premolars, then studying dental discolouration
and so on, so that the impact of dental disorders could be
prioritised. This study is preliminary one; two other investigations of the societal impact of dental appearance
in the workplace are planned.
Today, the self-image is manipulated to optimise
physical appearance. Aesthetics now occupies a prominent place in which dental care is justified. In addition to
the concept of health, factors such as social position,
seduction, beauty, youth and well-being must be considered; Tirlet [22] considers these the main reasons for
most dental consultations and, with the increase in longevity, demand will grow!

6. CONCLUSION
WHO defines health as a state of complete physical,
mental and social well-being; the teeth contribute to this
balance. For centuries, portraits did not reveal the teeth.
Today, the world in which we live, with its focus on
communication and image, makes the teeth a very important appearance factor. The results of this study would
suggest that having an ideal dentition can make it 4.8
times more likely that others will desire to enter into a
relationship with such a female person. Hitherto studies
have used volunteer panels to evaluate factors influencing physical attractiveness; this new methodology, using
Internet dating sites, represents a real innovation since it
allows the opinions of observers unaware of the purposes
of a study to be collected.

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